[在血管外科高创伤性手术麻醉管理中辅助肺通气]

Anesteziologiia i reanimatologiia Pub Date : 2016-09-01
A E Bukarev, V V Subbotin, S A II'in, V A Sizov, S A Kamnev, A V Sitnikov
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引用次数: 0

摘要

背景:手术中拒绝长时间机械通气,转而支持通气模式,并在手术结束后立即拔管可能是预防术后呼吸系统并发症的方法。目的:通过开发和实施麻醉管理复合支持通气模式,提高肾下主动脉损伤患者的手术治疗效果。材料与方法:对接受肾下主动脉手术的患者进行两期临床试验。在第一阶段,评估患者是否有机会立即或早期拔管并开始支持通气。第二阶段将术中通气时的支持方式引入临床。结果:根据现有的数据,我们得出结论,尽管手术时间长,手术创伤大,但并非所有患者都需要术中和术后机械通气。纳入麻醉支持通气方案可减少麻痹药物的需求及其副作用。结论:麻醉中采用支持通气方式,术后及时、早期拔管,减少危重事件和呼吸并发症的发生。
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[SUPPORT LUNG VENTILATION IN COMPLEX OF ANESTETIC MANAGEMENT DURING HIGH TRAUMATIC OPERATIONS IN VASCULAR SURGERY.]

Background: Rejection from prolonged mechanical ventilation with conversion to support ventilation modes during the surgery and subsequent immediate extubation at the end of the surgery could be the method ofprophylaxis ofpostoperative respiratory complications.

The aim: To improve the results of surgical treatment of patients with infrarenal aorta injury due to the development and implementation to the anesthetic management complex the modes of support ventilation.

Materials and methods: 2-staged clinical trial on patients undergoing surgery on infrarenal aorta was conducted. At the 1st stage patients were assessed for opportunity of immediate or early extubation and support ventilation initiation. At the 2nd stage support modes during the intraoperative ventilation were introducted into clinical praxis.

Results: Based on received data we concluded that not everyone patient needed intra- and postoperative mechanical ventilation in spite ofprolonged duration of the surgery and large surgical trauma. Inclusion in the protocol of anesthesia support ventilation strategy decreases requirement ofparalytic agents and their side effects.

Conclusion: Applying the support ventilation modes during the anesthesia gives a chance of immediate and early extubation after the surgery and decreases the number of critical events and respiratory complications.

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